Журнал инфекционных заболеваний и терапии

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The Similarities and Differences of Anal High-Risk HPV Infection in HIV-Positive Women and Men

Xiaofei Zhang, Qiusheng Si

The incidence of HPV-related anal cancer keeps increasing in the Post-Antiviral Therapy (ART) era. It preferentially affects women, and most of the new cases come from certain high-risk groups, including Men who have Sex with Men (MSM) and HIV-positive (HIV+) individuals, especially HIV+ women. We recently conducted a single-institutional retrospective study focusing specifically on the similarities and differences in high-risk HPV (hrHPV) infection and their clinicopathologic correlation between HIV+ women and HIV+ men. We found that both HIV+ women and HIV+ men have a significantly higher rate of hrHPV infection than their HIV counterparts do, suggesting a synergistic relationship between HIV and hrHPV. Infection with other high-risk HPVs (ohrHPV) is much more common than the infection with HPV16 or 18. In addition, the hrHPV infection in HIV+ women and men possesses genotype profiles of greater complexity and a significantly higher rate of coinfecting with hrHPVs of multiple genotypes than their HIV-counterparts do. Our data strongly suggest that HPV16 is the most oncogenic subtype. Coinfection with more than one genotype of hrHPV, especially when one of them is HPV16, significantly increases the risk of developing a High-grade Squamous Intraepithelial Lesion (HSIL). In comparison with HIV+ men, HIV+ women have different hrHPV genotype profiles and higher rates of high-grade lesions. In this review, we summarized our findings and compared them with other recently published studies. We believe these results have important implications for developing more effective vaccination and surveillance guidelines.